The What Counts Task Force, a group of community benefit professionals convened by CHA to discuss questions from the field about what counts as community benefit, recently discussed the following questions and recommendations. Visit www.chausa.org/whatcounts for more "what counts" resources.

Question:Our hospital is considering providing financial support to help build a new and much needed sports park in a rapidly growing, lower income section of our city. The park project is being funded in partnership between the city and private donors, led by a non-profit fundraising board. The hospital's CHNA identified physical activity and obesity as needs and the implementation strategy called for "healthy behaviors across life span" and to address childhood obesity through an "Eat Live Play" program.Would the hospital's financial investment to help build a sports park in this area qualify as a community benefit expense?

Recommendation: This donation can be reported as community benefit under the following circumstance: 1) the park was not initiated as a marketing opportunity but in response to community need, 2) it will be accessible to low income persons (no fees, uniforms or membership requirements, transportation easily available) and the request for funds came from a government agency or nonprofit organization.

Question:Can hospitals report as community benefit programs that connect patients to resources in the community, like Health Leads? As more and more organizations focus on the social determinants of health, we are identifying workforce capacity to help patients connect to affordable housing, food security and employment. Does this count as community benefit if it is for our patients, but does go above and beyond clinical care?

Recommendation: Health Leads is a program used by health care providers to screen low-income families for basic needs such as food and heat that can affect their health and that connects them to community resources that meet those needs.

We recommend that the costs associated with Health Leads be reported as community health improvement in the following circumstances: Patients/individuals are referred for these services whether or not they are part of a population for which the organization bears financial risk (such as an ACO), and regardless of their insurance status. We also recommend that the hospital or health care organization sponsoring the Health Leads program identify needs associated with social determinants in their needs assessment/implementation strategy and indicate that Health Leads is part of a strategy to address those needs. The case is even stronger if the hospital or health care organization makes these services available to community members outside its patient population, such patients of an unaffiliated community clinic.

Tax Exemption/Community Health Update
The Internal Revenue Service (IRS) has released its 2016 Form 990, Schedule H and instructions. They have been updated to reflect the IRS final rules for community health needs assessments, implementation strategies, billing, collections and financial assistance. Other than making the form and instructions consistent with the final rules, there were no major changes.

As reported in our December update, we do not expect the tax-exempt requirements of the Affordable Care Act (community health needs assessment, implementation strategies, billing, collections and financial assistance) to be part of ACA repeal efforts, primarily because they were championed by Republican members of Congress. However, we have learned that employees from various federal offices have been told they cannot speak publicly about topics that are related to hospital community health needs assessment because of its tie to the ACA. The enforcement by IRS of the ACA requirements may be impacted. The drop in the number of uninsured persons, especially in Medicaid expansion states, has meant that many CHA facilities were able to use community benefit resources for upstream and other community-based health improvement activities. If the number of uninsured persons goes up, these activities may be jeopardized.

Funding for public health related activities is expected to be impacted by budget cuts and ACA repeal. The ACA created a Prevention and Public Health Fund to modernize the public health system, which has been used to create new programs such as the Tips from Former Smokers campaign and the Office of Adolescent Health, and has also enabled expansion of other programs. At this point, the Prevention Fund is investing in many core public health programs, such as vaccine funding. Eliminating the ACA Prevention Fund would take away about 12 percent of the CDC budget.

CHA Sponsor at This Year's ACHI Meeting
The Catholic Health Association will be a sponsor of this year's Association for Community Health Improvement's annual meeting in Denver March 9-11. Visit our booth to learn more about CHA's community benefit resources and initiatives. Also, CHA will be hosting a luncheon for its members at the conference on March 9 at 11:45 a.m. If you are a CHA member and would like to attend this networking event, please contact Debbie Morrow at dmorrow@chausa.org.

Registration and Call for Presentation Now Open for CHA Annual Assembly
Registration for the 2017 Assembly is now open. The assembly will take place June 11-13 in New Orleans at the Hilton New Orleans Riverside hotel. The assembly is the only convening of the leadership of Catholic health care organizations from across the nation. Prior to the start of the assembly, CHA will convene a program on community benefit. Don't miss this opportunity to connect with ministry colleagues from across the country and learn how our faith-driven mission is a force for the common good. For information about speakers, schedule, location and registration please visit www.chausa.org/assembly.

The Call for Assembly Presentations is also open. Deadline for submitting proposals for breakout presentations is March 10. Please submit proposals about programs, services and innovations you believe will benefit other ministry organizations. You can find full details at http://www.chausa.org/callpresentations.

CHA Releases Resource on Health Care and Faith Community Partnerships
CHA has just released a new resource and video that make the case for increased collaboration between health care organizations and faith communities to improve the lives of older adults. The resource, Improving the Lives of Older Adults through Faith Community Partnerships: Healing Body, Mind and Spirit, provides examples of current partnerships, insights and other important information hospitals and senior service providers can use to discern potential new collaborative measures. It also speaks to parishes and other faith communities, offering tips for reaching out to health care providers. The resource and video can be accessed at https://www.chausa.org/eldercare/overview.

CHA Request for Health Equity Programs
April is National Minority Health Month. This year's theme is "“Bridging Health Equity Across Communities," with a focus on addressing the social determinants of health. To help the ministry consider our call to create health equity, during the month of April CHA would like to highlight programs from across Catholic health care. Please help us to highlight your efforts and share practices across the membership. If you have a program aimed at ending disparities in health care, please share the title, a brief explanation of the program, and a contact person, by emailing Kim Van Oosten at kvanoosten@chausa.org.

"Rolling Back Inclusion" tracker provides updates on threats to federal community development resources
In order to ensure public awareness, The Democracy Collaborative has developed the Rolling Back Inclusion tracker. The tracker will provide continuous updates regarding the status of inclusive community development programs at the Federal level so that efforts to eliminate these critical resources for improving community health and well-being do not pass by under the radar.

New Report from AHA's Center for Healthcare Governance
In January the American Hospital Association's (AHA) Center for Healthcare Governance released a new report The Leadership Role of Nonprofit Health Systems in Improving Community Health. This report builds on earlier reports from the AHA's Center for Healthcare Governance to discuss the important role health systems and their boards can play in creating healthier communities. This report discusses the complex challenges involved in community health improvement and makes the case for why health systems should take a substantial role in the multi-sector collaborative efforts necessary to achieve significant impact.

Essential Hospitals Take Action on Population Health
America's Essential Hospitals, with funding from the Robert Wood Johnson Foundation, has developed two resources to help their members move forward with population health improvement efforts. The first resource, Findings from Moving to Action for Hospitals and Population Health, identifies barriers to progress, potential keys to success and resource needs to support population health work. The second resource, A Road Map to Community-Integrated Health Care, lays out three operational objectives for hospitals: build a foundation for population health, assemble and align needed resources and implement community integrated health care. Each objective includes specific strategies and strategic steps, as well as illustrative examples from essential hospitals.

E-Cigarette Use Among Youth and Young Adults
The 2016 Surgeon General's Report on Smoking and Tobacco focuses on e-cigarette use among youth and young adults. While conventional cigarette smoking has declined over the past several decades among these groups, in recent years the U.S. has seen substantial increases in the use of electronic cigarettes among these populations. The report discusses the public health implications of the use of these products and suggests that action is needed at the local, state and federal levels. Actions could include incorporating e-cigarettes into smoke-free policies, preventing access to e-cigarettes by youth, price and tax policies, retail licensure, regulation of e-cigarette marketing likely to attract youth, and educational initiatives targeting youth and young adults.

Call for Proposals – Root Cause Coalition Annual Meeting
The Root Cause Coalition has opened its call for proposals for its 2nd Annual National Summit on the Social Determinants of Health, scheduled for Oct. 9-10, 2017, in Louisville, Ky. Proposals should address the "how" in tackling a broad range of social determinants of health so participants can learn more about directly addressing social determinants, successful initiatives, how challenges have been identified and overcome, best practices and necessary partnerships. To submit a proposal, please visit this link and complete the application by March 8, 2017. All applicants will be notified of proposal acceptance on or before May 1, 2017. Contact Monique Brigham, at mbrigham@rootcausecoalition.org for more information.

Upcoming CHA Events
Registration is now open for the following CHA programs. Use the links below for more information and to register.